凝血功能检测对脑出血患者的预后判断价值

目的探讨凝血功能检测对脑出血患者的预后判断价值。方法对2005年1月～2011年1月收治的89例脑出血患者进行不同时间段、多个凝血功能指标检测,分析检测结果与患者预后的关系。结果在内皮素-1（ET-1）、抗凝血酶Ⅲ（AT-Ⅲ）、纤溶酶原激活剂抑制物-1（PAI-1）、血栓调节蛋白（TM）以及D-二聚体等5个凝血功能指标上,37例患者变化明显（观察组）,52例患者变化不明显（对照组）;两组凝血功能指标变化比较,在发病48 h后均已有统计学差异（P〈0.05）,观察组除AT-Ⅲ明显降低外,其他指标明显异常升高;观察组治疗良好率明显低于对照组（P〈0.01）,病残率高于观察组（P〈0.01）;观察组有8例死亡,而对照组无死亡病例。结论脑出血患者凝血功能指标变化显著者的预后较差;对脑出血患者进行凝血功能检测,有助于判断患者预后。

Value of blood coagulation function detection in prognostic judgment of patients with cerebral hemorrhage

Objective To discuss the value of blood coagulation function detection in the prognostic judgment of patients with cerebral hemorrhage.Methods Detection of various blood coagulation function indexes was made in different times among 89 patients with cerebral hemorrhage hospitalized from January 2005 to January 2011.Correlation between the detected results and the prognosis of patients were analyzed.Results The changes in five blood coagulation indexes such as endothelin-1(ET-1),antithrombin Ⅲ(AT-Ⅲ),plasminogen activator inhibitor-1(PAI-1),thrombomodulin(TM)and D-dimer of 37 patients(observation group)were obvious,and the changes in those indexes of 52 patients(control group)were not obvious.There were significant differences in changes of those indexes between the two groups 48 h after onset(P<0.05).In the observation group,AT-Ⅲ decreased significantly,while other indexes abnormally increased;the excellent rate of treatment was significantly lower than that in the control group(P<0.01);the disability rate was significantly higher than that of the control group(P<0.01).Eight cases of death occurred in the observation group,and there was no death in the control group.Conclusion The prognosis is poor in patients with cerebral hemorrhage who have obvious changes in their blood coagulation function indexes.Detection of blood coagulation function in patients with cerebral hemorrhage was helpful to determine the prognosis of these patients.